Product Benefit Table

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Benefits MAX+
Entry Age (Adult) Minimum – 18 years
Maximum – No capping
Entry Age (Child) Dependent Child (Floater/Multi individual) – 91 days to 25 years
Individual – minimum age of entry – 5 years
Policy Type Individual & Floater
Tenure 1 / 2 / 3 Years
Family definition up to 2A4C
Premium – 3 Zones Zone 1, 2 & 3
Premium Type Age Banded
Relationship Covered Individual – Self, Legally Married Spouse OR Live-in Partner (Same or Opposite Sex), Son, Daughter, Brother, Sister, Grandson, Granddaughter, Son-in-Law, Daughter-in-Law, Brother-in-Law, Sister-in-Law, Nephew, Niece, Parents and Parents-in-Law

Floater – Self, Legally Married Spouse OR Live-in Partner (Same or Opposite Sex), Dependent Children (Natural/Legally Adopted), Parents and Parents-in-Law
Base Sum Insured (BSI) 2 Lacs, 3 Lacs, 4 Lacs, 5 Lacs, 7 Lacs, 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs, 50 Lacs, 75 Lacs, 1 Crore, 2 Crores, 3 Crores, 4 Crores, 5 Crores and 6 Crores
Hospitalization
Treatment		 Room Rent Actuals up to Base Sum Insured
ICU Charges Actuals up to Base Sum Insured
Road Ambulance Cover (per hospitalization) Actuals up to Base Sum Insured
Day Care Treatments Actuals up to Base Sum Insured
Modern Procedures / Treatments Actuals up to Base Sum Insured for listed procedures
HIV / AIDS and STD Cover Actuals up to Base Sum Insured
Mental Illness Hospitalization Actuals up to Base Sum Insured
Obesity Treatment Actuals up to Base Sum Insured
Pre-Hospitalization Expenses (up to Base Sum Insured) 90 Days
Post-Hospitalization Expenses (up to Base Sum Insured) 180 Days
Claim Protect (Non-Medical Expense Waiver) Non-payable items will be covered (all 4 lists of Annexure I)
Domiciliary Hospitalization Actuals up to Base Sum Insured
Home Health Care Actuals up to Base Sum Insured
AYUSH Treatment Actuals up to Base Sum Insured
Organ Donor Expenses Actuals up to Base Sum Insured
Annual Health Check-up (Listed & Cashless) Covered
Super Reload (Unlimited Refill) From 2nd claim of Policy Life – Unlimited times (Covered up to Base Sum Insured)
Super Credit (Increases Irrespective of Claim) 100% of Base Sum Insured per year, up to 500% of Base Sum Insured (up to max of ₹3 Cr)
Durable Equipment Cover Limit
i. Ventilator
ii. Wheelchair
iii. Prosthetic device
iv. Suction Machine
v. Commode Chairs
vi. Infusion pump
vii. Continuous Passive motion devices (knee replacement)
viii. Oxygen concentrator 		Combined Sub-limit of INR 5 Lacs or up to BSI, whichever is lower
Advanced Health Check-up
(90 days waiting period)

List of Tests:
1. Computed tomography angiography (CTA)
2. Positron emission tomography (PET) Scan 		Listed & Cashless

Health Management Program(In-built covers)

Health Assessment™ Applicable once in a policy year, undertaken at our Network Providers / Empanelled Service Providers on a cashless basis or on digital basis
HealthReturns™ Applicable up to 100% of the premium

Optional Covers

Reduction in Specific Disease Waiting Period 2 years to 1 year
Reduction in Pre-Existing Disease Waiting Period Option 1 – 3 years to 2 years
Option 2 – 3 years to 1 year
Room Rent Type Options Option 1 – Single Private Room
Option 2 – Shared Accommodation
Per Claim Deductible Option 1 – INR 15,000
Option 2 – INR 25,000
Preferred Provider Network (PPN) Discount 10% discount applicable
Critical Illness Cover
(Initial Waiting Period – 60 Days
Survival Period – 15 Days) 		Critical Illness SI Options – INR 10 Lacs, 15 Lacs, 20 Lacs & 25 Lacs
Personal Accident Cover (AD + PTD + PPD) Personal Accident SI Options – INR 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs & 50 Lacs
Chronic Care (Day 1 In-patient Hospitalization)

Applicable for Listed Chronic Conditions:
  • Diabetes
  • Hypertension
  • Asthma
  • Hyperlipidemia
  • COPD
  • Obesity
  • Coronary Artery Disease (PTCA done prior to 1 year)
 		PED waiting period and Initial waiting period will be waived for the listed and accepted chronic conditions
Chronic Management Program (OPD) Applicable on Cashless Basis
Cancer Booster
  • Covers Pre & Post hospitalization medical expenses
  • Covers Day Care Treatment up to Sum Insured
Up to 100% of Base Sum Insured
Compassionate Visit Up to INR 50,000 for two-way travel fare if hospitalization exceeds 10 days
Second Medical Opinion for Listed Major Illness Applicable
Annual Screening Package for Cancer Diagnosed Patients INR 10,000 / Member / Policy Year

Waiting Period-Inbuilt Cover

Pre-Existing Disease (PED) Waiting Period 3 years
Specific Disease Waiting Period 2 years
Initial Waiting Period
(Excluding Accidental Hospitalization) 		30 Days